Recommendation Form

Office of Admissions and Scholarships De La Salle University, 2401 Taft Avenue, Manila 1004 Telephone Nos. (632) 5234230 (Direct); (632) 5244611 Ext. 166 Email: admissions@dlsu.edu.ph Website: www.dlsu.edu.ph

NAME OF APPLICANT

LAST

FIRST

MI

GENDER

SCHOOL SCHOOL ADDRESS The person named above is applying for admission at De La Salle University and you have been requested to provide a recommendation. In making the following ratings, please keep in mind that these will be used to compare the student with the other applicants. 5 EXCEPTIONAL INTELLECTUAL ABILITY STUDY HABITS MOTIVATION TO PURSUE COLLEGE STUDIES POTENTIAL FOR SIGNIFICANT FUTURE CONTRIBUTION IN THE FIELD RESOURCEFULNESS AND INITIATIVE EMOTIONAL MATURITY ADAPTABILITY TO NEW SITUATION LEADERSHIP QUALITIES 4 SUPERIOR 3 AVERAGE 2 FAIR 1 POOR

The University recognizes that some of its students may have special learning needs (disabilities) or differences that require learning support. Since it is of great importance to the University that all its students will be able to work towards the successful completion of their academic requirements, we need your assistance in answering the following questions to the best of your knowledge: 1. Does the applicant have any physical condition which may affect his/her performance in college? (Please check) NO YES If yes, please specify:

2. Does the applicant have any mental condition which may affect his/her performance in college? (Please check) NO YES If yes, please specify:

3. Does the applicant have any emotional condition which may affect his/her performance in college? (Please check) NO YES If yes, please specify:

4. Do you have negative observations about the applicant which may help us in evaluating his/her application to the University? (Please checK) NO YES If yes, please specify:

NAME (PLEASE PRINT) SIGNATURE POSITION DATE

Length of time acquainted with the applicant: Please return this appraisal to the applicant in a sealed envelope, with your signature across the seal. The applicant will then submit the sealed envelope to the Office of the Admissions and Scholarships, De La Salle University. Thank you very much.